Self-Service Analytics Solution Helps Answer Clinicians’ Pressing Questions
Coming from England more than a decade ago, Dr. Dan Low has watched closely as healthcare organizations across the United States — including Seattle Children’s — have moved from paper to electronic health records.
Low, an anesthesiologist at Seattle Children’s, believes electronic health record systems do a great job collecting data like height, weight, age, race/ethnicity, first language spoken, diagnosis, medications given and procedures performed. This information enables clinicians to take a deep dive when reviewing a single patient’s history.
The electronic systems, however, struggle to look at outcomes and trends across groups of patients or answer simple questions like: “How long do patients stay in recovery after a gastroenterology (GI) procedure?” or “Is treatment A or treatment B better for patients with this condition?”
Answering these types of questions at Seattle Children’s in the past could take months to investigate through a labor-intensive process. If changes are made based on the findings, it would then take months to retrieve and analyze new data to see if the change helped move the needle in the right direction.
To address this issue, Low was introduced to Ryan Sousa, chief data officer, who was already exploring how to do something very similar alongside Suzanne Spencer, director of clinical analytics.
Low and Sousa quickly aligned on a vision to develop a self-service solution that gives clinicians the power of data at their fingertips through simple searches that can be done in the amount of time it takes to drink a cup of coffee.
“This system makes sense with how a clinician thinks and their decision-making process,” says Spencer. “In just minutes, it creates transparency and uses data to drive improvements. It’s been transformational.”
Seeing the big picture
Graphic representations of the data generated from the self-service tool are intuitive to understand. They incorporate the best practice data science and improvement methodology developed by the Institute for Healthcare Improvement.
Embedded artificial intelligence also assists clinicians in interpreting the data. This dramatically reduces the time it takes to understand the data and gives data scientists and statisticians more time to work on other important projects.
This tool was so successful that MDmetrix was born in early 2018 — Seattle Children’s first commercial spinout company sponsored by Enterprise Analytics. The company offers various data analytics and clinical performance modules to improve operational and clinical outcomes in hospitals and surgery centers. It is currently being used in 16 organizations, including Seattle Children’s. Low serves as the company’s chief medical officer and Sousa is on the company’s advisory board. Seattle Children’s remains a major shareholder of MDmetrix.
Real-time data, real-time results
Options for data searches through MDmetrix are limitless.
Using the real-time data collected by the electronic health record, MDmetrix enabled Seattle Children’s Bellevue Clinic and Surgery Center to become the first surgery center in the country to stop the routine use of opioids for all outpatient surgeries.
Seattle Children’s anesthesiology team has also standardized certain operating room practices, which has led to shorter recovery times for patients undergoing GI procedures and significant improvements in keeping procedures running on time.
By understanding the data, teams can more quickly make improvements that lead to safer, more efficient and more equitable care across all patient populations. And, once they make changes, they can quickly and easily track their progress.
Co-inventors Low, Spencer and Sousa are amazed by the changes across the organization in such a short period of time and excited for what’s to come.
“We are about to accelerate the pace of change,” says Low. “We’ve seen that we can do 20 years of work in one year. I can’t wait to see what we are going to do in the next two to three years as this thing starts to blossom and bloom.”
Seattle Children’s remains a shareholder of MDmetrix. Low is also a founder and shareholder in MDmetrix. Sousa is a co-inventor and MDmetrix advisory board member with equity in the company. Spencer, also a co-inventor, would receive a revenue share if Seattle Children’s liquidates equity in the company upon an equity sale or acquisition.
How Seattle Children’s Surgery Center in Bellevue Went Opioid-Free
In late 2018, the anesthesiology team at Seattle Children’s Bellevue Clinic and Surgery Center was on a mission to reduce the use of opioids during outpatient surgeries.
According to the Centers for Disease Control and Prevention, two out of three drug overdose deaths in the United States involve opioids and about 128 Americans die every day from opioid overdose. In medicine, a simple surgery may be a person’s first introduction to opioid use, possibly opening the door for addiction.
Thanks to data compiled using MDmetrix and through researching successes at other healthcare institutions, the team was able to not just reduce opioid use, but eliminate it altogether.
How did it happen?
STEP 1: Understand patient outcomes.
The team first looked at patient outcomes after a tonsillectomy (removal of tonsils) — the most common type of surgery performed at Seattle Children’s in Bellevue. Using the analytics tool, they generated historical outcome data within minutes to track measures like length of time in recovery after surgery, pain scores after patients wake up from the procedure, how often they receive pain medications, how often patients experience nausea and vomiting (common side effects of opioids) and more.
STEP 2: Find alternatives.
The team found published research that showed how using certain non-opioid medications during surgery were equally as effective as using opioids.
STEP 3: Make the switch and track results.
On average, anesthesiologists use a combination of half a dozen or more medications to keep patients sedated during surgery. The team swapped one non-opioid medication at a time for an opioid and tracked the results based on the patient outcome measures defined during the first step of the process. If outcomes were the same or had improved, the team was able to refine the protocol further — either adjusting dosage or adding in another non-opioid medication in place of an opioid — and tracked the results.
The team completed each improvement process cycle within six to 12 weeks (each cycle previously took years). After two months, they successfully eliminated opioids from tonsillectomy surgery while still ensuring their patients were comfortable in recovery with minimal side effects from the anesthetic.
STEP 4: Repeat the process for all other surgical services.
Since starting this initiative, more than 10,000 patients have undergone surgery without opioids during their procedure. Seattle Children’s is now recognized as a national leader in opioid-free surgery, serving as a model for other organizations.